Anaesthesia in endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Anesthesiology
• Surgical Innovation

Background:

• Endoscopic sinus surgery (ESS) and functional endonasal endoscopic approach (FESS) are common procedures for various sinonasal disorders.
• Patient anatomy can be altered by previous surgeries or conditions like sinonasal polypoid disease.
• Selecting appropriate anesthesia is crucial for successful surgical outcomes and patient comfort.

Purpose of the Study:

• To evaluate anesthesia methods used in 1,460 patients undergoing ESS or FESS.
• To determine the optimal anesthetic approach for different endoscopic sinus surgery tasks.
• To ensure patient and surgeon comfort during sinonasal endoscopic procedures.

Main Methods:

• Retrospective analysis of anesthesia techniques in 1,460 patients operated on between 1987-2001.
• Inclusion of patients with diverse sinonasal conditions, including chronic infections, tumors, and smell disorders.
• Comparison of local anesthesia versus general anesthesia, including total intravenous anesthesia (TIVA) with laryngeal mask airway (LMA).

Main Results:

• A variety of sinonasal disorders were treated, with many patients having complex histories.
• Local anesthesia is suitable for minor procedures and training.
• General anesthesia is generally preferred by patients and surgeons for these procedures.

Conclusions:

• Total intravenous anesthesia (TIVA) combined with oxygen-enriched air via a laryngeal mask airway (LMA) is the preferred anesthetic method.
• This approach facilitates optimal surgical results and comfort for both patient and surgeon.
• A differentiated anesthetic approach is necessary for diverse endoscopic sinus surgery tasks.